Tailoring tacrolimus therapy: the influence of pharmacokinetics and pharmacogenomics

In the field of immunosuppression after organ transplantation, it is currently impossible to predict individual immunosuppressive requirements. Some immunosuppressants are dosed empirically (e.g. mycophenolate mofetil), whereas dosages of other drugs (e.g. cyclosporin and tacrolimus) are based on arbitrarily designed therapeutic level targets. A number of studies presented at the American Transplant Congress (ATC) [Washington DC, US; May−June 2003] discussed ways of improving immunosuppressive therapy with the calcineurin inhibitor tacrolimus ['Prograf'] in the context of pharmacokinetic and pharmacogenetic factors. The studies examined the effects of factors including long-term administration, gender and concomitant therapy on the pharmacokinetics of tacrolimus, in addition to those of genetic polymorphisms.